179305 (SFD)DEPARTMENT OF BUILDING & SAFETY
0 COUNTY OF RIVERSIDE 0
FIELD OFFICE
CONSTRUCTION ESTIMATE
SET BACK
ELECTRICAL
FEES
PLUMBING FEES
1st FI. r'
2nd F1.
Par. je% !a
Liar.
Car P.
Wall
Sq. Ft. @, 6
NO.
R
NO.
Sq. Ft. @
20NE
Sq. Ft. 0--
f3
Sq. Ft. ••�►• POLES
DATE
Sq. Ft. @ SIGNS
DRAINAGE PIPING
TRANS. AND/
Sq. Ft. @ OR T. CLK.
DRINKING FOUNTAIN
Sq. Ft. @ MOTOR H. P.
C°
URINAL
MOTOR H.P.
WATER PIPING
ESTIMATED VALUATION 11 : `
MOTOR
M.P.
FLOOR DRAIN
MECHANICAL FE S
MOTOR
M.P.
WATER'SOFTENER
VENT SYSTEM � FAN ❑ EVAP. COOL FoL.HOOD
MOTOR
H.P.
WASHER (AUTO y(DISH)
APPLIANCE
V
I
FIXTURES
MECHANICAL FEE $
GARBAGE DISPOSAL
FURNACE ❑ UNIT ❑ WALL ❑ FLOOR ❑ SUSPENDED
OUTLETS
LAUNDRY TRAY
AIR HANDLING UNIT
SUB -PANEL
G O P
KITCHEN SINK
GAS PIPE ❑ NATURAL ❑ L.P,G. ❑ OIL
PERMIT NUMBE
^ WATER CLOSET
COMPRESSOR HP
RANGE AND/OR OVEN
LAVATORY
APPLIANCE VENT
L.
WATER HEATER
SHOWER
ABSORPTION SYSTEM O B.T.U.
SPACE HEATER
j BATH TUB
INCINERATOR DOMESTIC ❑ INDUS. ❑ COMM.
SUPP. TO PERMIT
CONSTRUCTION POLE
`
-t 7
WATER HEATER
HEATING SYSTEM XFORCED ❑ GRAVITY
SERVICE ENTRANCE
--
d:2
SEWAGE DISPOSAL
BOILER B.T.U.
RESID. IC SQ. FT.
HOUSE SEWER
PERMIT FEE
BOND
GARAGE zQ 50. FT.
1
GAS PIPING
INSPECTOR
PERMIT FEE
PERMIT FEE 7
PE MIT NUMBER
REN.
JDBL.
JTOTAL FEE,d�
rr 7{
HEAT & VENT FEE
--=�
PLN. CK. FEE
- t y ��'
CONST. FEE
=�
ELEC. FEE
x
PLUMB. FEE
J F M - A I X' J
In
J A
5
O N D
SET BACK
LOT SIZE
USE #
JOB ADDRESS OWNER
F
S
R
20NE
USE O BUILDING
DATE
..
PLAN CHECK FEE $
2 :7++
-
CHECKED BY
COMMUNITY
VALUATION
OFFICE
�IC.C.
JUNITI
V
I
MECHANICAL FEE $
qwma dk
G O P
TYPE
LEGAL DES RIPTI ON
PERMIT NUMBE
CONSTRUCTION FEE $
L.
SPEC. INSP.
SUPP. TO PERMIT
`
-t 7
ELECTRICAL FEE $
--
d:2
PLAN CHECKER
BOND $
BOND
CASH
PLAN FILE It
FINAL DATE
INSPECTOR
I
PLUMBING FEE $
f ,i
fes-
X v ?0
TOTAL FEES
r
$ �.+�
COMMENCED
- ,�
THIS PERMIT SHALL BECOME VOID IF WORK IS NOT
WITHIN 60 DAYS. CESSATION OF WORK FOR 120 DAYS SHALL ALSO
CAUSE PERMIT TO BECOME VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS
CASH CHECK d M. o. N.c.
RECEIVED BY
SEWAGE SYSTEM
PERMIT WILL BE DONE IN ACCORDANCE WITH THE LAWS OF RIVER-
SIDE COUNTY AND THE STATE OF CALIFORNIA. I ALSO AGREE TO
T ,r
�:.
LLP
CARRY COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLI-
ANCE WITH LAWS OF THE STATE OF CALIFORNIA�COVERING CON-
-
TRACTORS IS ALSO GUARANTEED.
NAME OF CONSTRUCTION
LENDER
OWNER
C011T C R '
cxo"y Corp.
BRANCH OFFICE
ADDRESS
•
ADORES • •
ADORE
CITY
STATE
NO LENDER INVOLVED
4023 RLmh Street
INFORMATION
AN
TEL. NO.
TEL. NO.
544#wi011
/l
LICENSE NO.
284-208 12/68
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